Individual
JOHN BRADFORD LICHLYTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, NP-C, CEN
Contact information
Practice address
410 N STATE OF FRANKLIN RD STE 130, JOHNSON CITY, TN 37604-6972
(423) 431-2477
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
224266
TN
363L00000X
Nurse Practitioner
15689-33
WI
363L00000X
Nurse Practitioner
Primary
34973
TN
363LF0000X
Family Nurse Practitioner
34793
TN
Other
Enumeration date
08/21/2023
Last updated
09/26/2025
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